From time to time I have shared with you the "bumps in the road" that are a familiar part of the lung-transplant recovery program. Lee has been experiencing those "bumps" in the form of skin cancer for the past year and half. Most of these have been basal cell; however more than three have been squamous cell carcinoma. Unfortunately, the medication he must take to prevent rejection is not kind to his skin, consequently he has had numerous biopsies. Even though he feels good, has lots of energy and has been able to recover independence, those nasty skin cancers have been very annoying and perplexing.
So............this is where we are today. This past November, a biopsy of a small lesion on his forehead was biopsied for basal cell ca. The past two months that has changed and the size has increased from that of a nickel to a silver dollar, and is now squamous cell ca.. His dermatologist has referred him to a Moh's specialist at Duke. He had his first consult there this past Tuesday, and is scheduled for surgery (in the office) on Friday, April 25, to remove all of it.
To explain further: A basal cell carcinoma is the bottom layer of the epidermis, or outer layer of skin. Cancer in this area is slow-growing and takes a longer time to enlarge to surrounding areas. It begins as a papule and enlarges peripherally, developing a central crater that erodes, crusts and bleeds. Usually caused by excessive exposure to the sun.
A squamous cell carcinoma is a thin flattened layer of cell above the basal or bottom layer. these cells present as a nodule and even though are also slow-growing, can spread to adjacent lymph nodes.
This type of skin cancer is also caused by excessive exposure to the sun or ultra-violet rays. I guess all those years of working on his farm with no sunscreen have undermined what is happening today.
The Moh's procedure will take many hours. Lee will be awake because it will be done under local. He will be given a break, and will be given time to eat. Depending on the size, it may take a couple of hours or eight to nine hours.
Prior to that.............we are leaving tomorrow for the beach and will look forward to enjoying some time with some of our children and grandchildren. This is always a great time for Lee. He loves the beach and apparently the beach loves him because he improves with each visit!
Hoping all of you have a wonderful Easter with many blessings of the promised life we have been given.
More Later.....................................Brenda
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